Archived: Home Instead South Devon

Home Instead Senior Care South Devon is based in Paignton, Devon and provides a domiciliary care service to people living in their own homes in the South Devon area. At the time of this inspection they provided personal care to 37 people. Home Instead Senior Care is part of a franchise that delivers care to people in many areas of the United Kingdom and 17 countries across the world. The service offered includes personal care such as assistance with bathing, dressing, eating and medicines. The staff who support people wish to be known as 'caregivers’ and therefore we have used this term throughout this report.

The service is a family run business. The providers are a husband and wife team who are fully involved in the day-to-day management of the service. One of the providers is also the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider told us their aim was “To become the UK’s most admired care company through changing the face of ageing.” They provided a highly bespoke service for each person, carefully recruiting caregivers to match the personality and needs of individuals. The provider took care to make sure every aspect of the service people received was safe, and people were protected from the risk of harm or abuse. The provider was very selective when recruiting new caregivers, taking care to gather sufficient references and checks to ensure the caregivers were entirely trustworthy, honest and had the right skills and qualities for the post. They looked for staff with a ‘good heart’ and with good communication skills. Caregivers confirmed their recruitment process was thorough, for example a caregiver told us they had been “Very well recruited.” All caregivers received thorough training at the start of their employment including safeguarding and health and safety topics. They also received ongoing training and updates on topics relevant to the needs of people using the service, including dementia awareness.

All caregivers were introduced to people before they began providing care, and if the person did not feel the caregiver was suitable the person’s views were respected. They provided a consistent service, with most people receiving care from a small team of two caregivers they knew and trusted who visited them at the same times each week. When their regular caregivers were on leave the cover was always provided by a caregiver they knew, and who had been previously introduced to them. The service aimed to give people the time they needed to complete all tasks without feeling rushed and therefore the minimum length of each visit was one hour. There was a strong emphasis on providing care with compassion, respect and dignity. People told us they had built up a close trust and friendship with their caregivers and praised the caregivers. One person described the service as “Wonderful!” and went on to say “They are friends. They are human. They are lovely.” Another person who enjoyed outings with caregivers told us, “They are my friends. We go places.”

Each person had a care plan in place that set out in detail their health and personal care needs, how they wanted to be supported, their daily routines and preferences. The care plans were regularly reviewed and updated. Where changes were identified peoples’ care packages were amended to meet their changing needs. The service was flexible and responded positively to people's requests where possible.

The provider demonstrated a clear understanding of some of the factors that may affect a person’s ability to remain living safely in their own homes. Risk assessments were carried out before the service began to ensure the environment was safe. The provider and caregivers demonstrated concern for each person’s welfare and safety and, where risks were identified, they explored every possible angle to find solutions and enable people to remain living safely in their own homes. The provider had recognised the risks to vulnerable people of fraud and scams and had provided training to caregivers on this topic. They had also held ‘Fraud and Scam Awareness’ workshops for members of the public, speaking with local organisations and groups. Where they had identified people who may be at risk they had arranged meetings with the local police to help them find solutions and address the problem.

They had also provided a range of training for caregivers on dementia awareness. Caregivers had become ‘dementia friends’ which means they had gone out into the community to raise awareness of the condition to members of the public, families, and members of staff in local shops and businesses. The providers had built up close links with local services such as supermarkets, raising awareness of the needs of people who used their service. This promoted a greater understanding and respect for people living with dementia who used the service when they went into the community.

Where people required assistance with their medications, safe systems were followed. All caregivers had received training at the start of their employment to ensure they were competent to assist people with their medications. A caregiver told us the training was “Ongoing, all of the time”.

The provider and senior management team promoted a sense of compassion and caring for everyone involved with the organisation. The provider told us their principle objective was “To provide supportive care and companionship which both encourages and enables our clients to remain independent.” Throughout our inspection we saw and heard how caregivers aimed to please, taking time and trouble to make sure every small detail of the care they provided met the person’s individual needs and wishes. A caregiver told us “This company takes care to the ‘Nth’ degree to get the package of care right. It’s marvellous.”

Caregivers were positive and enthusiastic about their jobs. They told us the agency was well-run. They received regular supervision and plenty of opportunity to share and discuss any problems or concerns. Staff meetings were held regularly, and there was also an emphasis on having fun, with social events and competitions. There were also awards and recognition for exceptional service. Comments from caregivers included, “This agency is like ‘the cream’. It’s all organised. It’s all planned. It’s marvellous,” “I love this job” and “You can phone them at any time – they support you. They have been lovely. Really, really nice. A lovely company.”

The providers had systems in place to monitor the service and identify any areas where improvements were needed. They listened closely to the views of people who used the service and their families to constantly monitor and improve the service. All clients received a quality assurance visit or telephone call every three months to ensure they were entirely satisfied with the service. The agency also used an external company on an annual basis to conduct independent and anonymous surveys. A person who used the service told us “[Management member’s name] visits quite often to do spot checks and check I am happy with the service.” There was an ethos of learning from mistakes, and making improvements to prevent recurrence. Caregivers were also encouraged to discuss issues and problems during staff meetings, and to share good practice.